Ricci Chapter 8 - Test Bank - 4th Edition Exam Questions And Answers

1. A 58-year-old client comes to the clinic for evaluation. After obtaining the client's history, the nurse suspects endometrial cancer. Which information would lead the nurse to this suspicion? A. use of oral contraceptives between ages 18 and 25 B. onset of painless, bright red postmenopausal bleeding C. menopause occurring at age 46 D. use of intrauterine device for 3 years - ANS Answer: B Rationale: Any episode of bright red painless bleeding occurring after menopause needs to be investigated. Abnormal uterine bleeding in postmenopausal women should be regarded with suspicion. Oral contraceptive use is associated with cervical cancer. Late menopause (after age 52) is associated with endometrial cancer. Use of an intrauterine device is not associated with endometrial cancer. 2. A woman is to have a Papanicolaou test. When teaching the woman about this test, the nurse would emphasize which instruction to the client? A. "Refrain from sexual intercourse for 1 week before the test." B. "Wear cotton panties on the day of the test." C. "Avoid taking any medications for 24 hours." D. "Do not douche for 48 hours before the test." - ANS Answer: D Rationale: The nurse should instruct the woman not to douche for 48 hours before the test to prevent washing away cervical cells, which might be abnormal. Sexual intercourse should be avoided for 48 hours before the test. Wearing cotton panties is unrelated to preparation for a Papanicolaou test. Medications do not need to be withheld before the test. 3. A woman comes to the clinic for a routine checkup. After obtaining the client's history, the nurse identifies that the client is at increased risk for cervical cancer based on her history of exposure to which virus? A. hepatitis B. human papillomavirus C. cytomegalovirus D. Epstein-Barr virus - ANS Answer: B Rationale: Human papillomavirus is a major causative factor for cervical cancer. Hepatitis, cytomegalovirus, and Epstein-Barr virus are not associated with the development of cervical cancer. 4. A client is scheduled to have a Papanicolaou test. After the nurse teaches the client about the Papanicolaou test, which client statement indicates successful teaching? A. "I need to douche the night before with a mild vinegar solution." B. "I will take a bath first thing that morning to make sure I'm clean." C. "I will not engage in sexual intercourse for 48 hours before the test." D. "I will get a clean urine specimen when I first wake up the morning of the test." - ANS Answer: C Rationale: The woman should refrain from sexual intercourse for 48 hours before the test because sperm can obscure the specimen. Douching should be avoided for 48 hours before the test to prevent washing away cervical cells, which might be abnormal. Although a bath is an appropriate hygiene measure, it is not required before a Papanicolaou test. Collecting a urine specimen also is not necessary. 5. Which finding obtained during a client history would the nurse identify as increasing a client's risk for ovarian cancer? A. multiple sexual partners B. consumption of a high-fat diet C. underweight D. grand multiparity (more than five children) - ANS Answer: B Rationale: Risk factors for ovarian cancer include a high-fat diet, obesity, nulliparity, early menarche, late menopause, and increasing age. Having multiple sexual partners is a risk factor for cervical cancer. 6. A client is scheduled for cryosurgery to remove some abnormal tissue on the cervix. The nurse teaches the client about this treatment, explaining that the tissue will be removed by which method? A. freezing B. cutting C. burning D. irradiating - ANS Answer: A Rationale: Cryosurgery destroys abnormal cervical tissue by freezing. Conization involves cutting out a cone-shaped section of tissue. Laser therapy destroys cervical tissue by using highenergy light to burn it off. Radiation therapy involves irradiating the tissue for destruction. 7. Which statement best indicates that a client has taken self-care measures to reduce her risk for cervical cancer? A. "I've really cut down on the amount of caffeine I drink every day." B. "I've thrown out all my bubble baths and just use soap and water now." C. "Every time I have sexual intercourse, I douche." D. "My partner always uses a condom when we have sexual intercourse." - ANS Answer: D Rationale: Unprotected sexual intercourse is a risk factor for cervical cancer. Use of barrier methods of contraception such as condoms is a key measure for reducing the risk for cervical cancer. Cessation of smoking and drinking alcohol, not caffeine, also are effective measures for risk reduction. Eliminating irritants such as bubble baths is a general measure to reduce perineal irritation and urinary tract infections. Douching has no effect on risk reduction for cervical cancer. 8. A client is suspected of having endometrial cancer. The nurse would most likely prepare the client for which procedure to confirm the diagnosis? A. transvaginal ultrasound B. colposcopy C. Papanicolaou test D. endometrial biopsy - ANS Answer: D Rationale: An endometrial biopsy is the procedure of choice to make the diagnosis of endometrial cancer. A transvaginal ultrasound may be used to evaluate the endometrial cavity and measure the endometrial thickness to detect endometrial hyperplasia, but it does not confirm the diagnosis. Colposcopy is used to diagnose cervical cancer. A Papanicolaou test screens for abnormal cervical cells. 9. Which description would the nurse include when teaching a client about a scheduled colposcopy? A. "A gel will be applied to your abdomen and a microphone-like device will be moved over the area to identify problem areas." B. "A solution will be wiped on your cervix to identify any abnormal cells, which will be visualized with a magnifying instrument." C. "Scrapings of tissue will be obtained and placed on slides to be examined under the microscope." D. "After you receive anesthesia, a small device will be inserted into your abdomen near your belly button to obtain tissue samples." - ANS Answer: B Rationale: A colposcopy is a microscopic examination of the lower genital tract using a magnifying instrument. Use of a microphone-like device over the abdomen describes an ultrasound. Obtaining tissue scrapings that are examined under a microscope describes a Papanicolaou test. Insertion of a device under anesthesia near the umbilicus describes a biopsy obtained via laparoscopy. 10. The nurse is preparing a presentation for a local women's group about methods to reduce the risk of reproductive tract cancers. Which action should the nurse include? A. blood pressure evaluation every 6 months B. yearly Papanicolaou test starting at age 40 C. condom use with every sexual encounter D. consumption of two to three glasses of red wine per day - ANS Answer: C Rationale: Staying healthy is a major way to reduce one's risk for cancer. Current recommendations include: using a condom with every sexual encounter; having blood pressure evaluated at least every 2 years; undergo a Papanicolaou test every 1 to 3 years, if sexually active, starting at age 21; and consuming alcohol in moderation (not more than one drink per day), if at all. 11. The daughter of a woman who has been diagnosed with ovarian cancer asks the nurse about screening for this cancer. Which response by the nurse would be most appropriate? A. "Currently there is no reliable screening test for ovarian cancer." B. "A Papanicolaou test is almost always helpful in identifying this type of cancer." C. "There's a blood test for a marker, CA-125, that if elevated indicates cancer." D. "A genetic test for two genes, if positive, will identify the ovarian cancer." - ANS Answer: A Rationale: Currently there are no adequate screening tests for ovarian cancer. A Papanicolaou test is used to screen for cervical cancer. The CA-125 marker may be elevated in women with ovarian cancer, but it is not specific for this cancer and may be elevated in other malignancies. Genetic testing via BRCA-1 and BRCA-2 provides information about a woman's risk but does not predict if the woman will develop cancer. 12. After teaching a group of young women how to reduce their risk for ovarian cancer, the nurse determines that additional teaching is needed when the group identifies which element as a way to reduce risk? A. pregnancy B. use of oral contraceptives C. use of feminine hygiene sprays D. breastfeeding - ANS Answer: C Rationale: Risk reduction strategies include pregnancy, use of oral contraceptives, and breastfeeding. Women should avoid using talc and hygiene sprays on the genital area. 13. A woman is diagnosed with adenocarcinoma of the endometrium in situ. The nurse interprets this as indicating which information about the cancer? A. spread to the uterine muscle wall B. found on the endometrial surface C. spread to the cervix D. invaded the bladder - ANS Answer: B Rationale: Carcinoma in situ is found only on the endometrial surface. In stage I, the cancer has spread to the uterine muscle wall. In stage II, it has spread to the cervix. In stage IV, it has invaded the bladder mucosa with distant metastases to the lungs, liver, and bone. 14. When preparing a woman with suspected vulvar cancer for a biopsy, the nurse expects that the lesion would most likely be located at which area? A. labia majora B. labia minora C. clitoris D. prepuce - ANS Answer: A Rationale: The diagnosis of vulvar cancer is made by biopsy of the suspicious lesion, which is most commonly found on the labia majora.